10例肿瘤导致ABO血型系统抗原减弱病例分析

Study on Reduction of ABO Group Antigen of 10 Cases of Tumour

探讨肿瘤因素导致ABO血型系统抗原减弱所引起的定型困难,解放军总医院2002年以来,在血型鉴定时发现10例肿瘤患者血标本,正向定型出现弱凝集或不凝集;反向定型正常,正反定型不一致。其自身对照为阴性,且排除假凝集所致。通过吸收放散、唾液型物质中和试验、H抗原强度等实验检测弱抗原,并对患者进行随访,在患者病情缓解后重新进行血型鉴定。结果表明10例受检者红细胞上确有弱抗原存在,其中3例血清学实验呈现较明显亚型特征,但肿瘤经过治疗缓解后,亚型特征逐渐减弱甚至消失,定型恢复正常。说明某些肿瘤可以导致ABO血型系统抗原减弱,出现正反定型不一致,血清学呈现亚型特征,应综合病情、输血史、家系调查及特殊血清学检查来确定血型,并与亚型相鉴别。

To investigate identification difficulty of ABO blood grouping induced by reduction of antigen in tumour patients, 10 samples were collected from different patients who first applied to transfuse blood components in General hospital of PLA from 2002. Weak agglutination reactions and discrepancies between forward and reverse typing in ABO grouping were found in these 10 samples. All self-control tests were negative, and pseudo agglutina- tion reactions were excluded. Adsorption-elution test, salivary ABH inhibition test and H antigen test were performed , and before-mentioned tests were detected again in order to confirm ABO group when their cases of illness had been alleviated. The results showed that there were weak antigen on the surface of erythrocyte in 10 tumor patients,of which 3 samples presented typical characteristics of subgroup. Characteristics of subgroup became weak and even disappeared with improvement of illness, and the blood group of all samples could be identified properly. It is con- cluded that some tumors can induce reduction of ABO blood group antigen and discrepancies between forward and reverse typing. Illness , family investigation, history of blood transfuion, and special serological tests should be proformed in order to distinguish ABO blood groups from subgroups.